Background: Thoracic surgeons remain involved with the long-term care of their cancer patients, usually in surveilling for recurrence. However, with an increasing survivor population, little is known on their other supportive needs.
Objectives: The goal of this quality improvement project was to characterize the prevalence and level of interest in supportive care needs among individuals with a history of lung or esophageal cancer surgery. Special attention was given to how needs changed over time throughout a patient’s care/survivorship.
Methods: This was a single-institution prospective study conducted at a major urban medical teaching institution. An outreach navigator offered a needs assessment survey to all outpatients followed in a long-term thoracic surgery clinic for lung and esophageal cancer surveillance. Patients were asked to rate their level of interest for help in the past month on a series of supportive care needs. The questionnaire consisted of 14 items measured on a scale of 1 to 5. The level of interest for help patients provide in relation to a given need, such as nutrition, were measured on an ordinal scale of 1 to 5 that correspond to “no interest” (= 1), “interest but solved” (= 2), “low interest” (= 3), “moderate interest” (= 4), and “high interest” (= 5). Patients were placed into subgroups based on the time (months) from their original cancer diagnosis: 0-12, 13-24, 25-60, and >60. The survey aimed to reduce respondent burden and be feasible for use in a fast-paced cancer care setting.
Results: 241 patients completed the survey. The top 3 needs included diagnosis/treatment (31%), exercise (30%), and fatigue (26%). Patients 0 to 12 months required the most care needs, listing diagnosis/treatment, exercise, and nutrition as top factors. As patients progress farther into survivorship, interest in supportive care needs diminished.
Conclusion: Lung and esophageal cancer survivors have unmet educational and emotional needs. Interest in supportive care services are highest in the first year following diagnosis; thus, interventions would have the greatest impact on overall well-being. Why needs decrease over time may be due to an earlier stage of disease with little to no treatment regimens, and thus patients are able to return to life as normal. Pain, depression, and anxiety can elevate the level of interest in supportive care needs and need for intervention. By addressing unspoken needs, patients may be more motivated to follow their treatment plan, feel empowered to self-advocate for their needs, and report higher patient satisfaction with the care team.